Cognitive Analysis On Diabetic Mellitus Patients With Intensive Treatment By Insulin Pump And Evaluation On Its Standard Management

Background:Diabetes mellitus has been the universal public healthy question threatening the health of our country people seriously. The life-long of illness, the seriousness of complications, as well as the limitations of treatment gave patients the enormous physical and psychological pain and pressure, and bring heavy healthy and economic burden to our society. How to reduce high blood sugar, prevent and treat diabetes and its complications effectively, which is urgent.Diabetic patients with insulin pump continuous subcutaneous insulin infusion therapy, has been confirmed to be the best means of controlling blood sugar by clinical validation at home and abroad, and can effectively prevent and delay chronic complications and its development of diabetes mellitus.Because of my insulin pump prices more expensive, the later introduction, and the use of short-term, the broad masses of patients and even medical workers is still relatively lack of knowledge of insulin pump intensive therapy. The application status of insulin pump intensive therapy, the existing problems in areas is lack of information also in the course of treatment, insulin pumps because of their characteristics and the use of non-standard management, there are a number of issues, and thus cause the patient harm.This study investigated the status of insulin pump use and related knowledge about intensive therapy for hospitalized diabetes insulin patients, then analyzing the existing problems, and looking for the weak links in knowledge to further ensure the proper use of insulin pump and further improve medical and health services in the treatment of type 2 diabetes and to the level of standardization of medical services. This study based on abroad DM Evidence-based clinical management guidelines, refering advanced nursing theory and clinical path of thought, combining with China's actual situation, as well as the characteristics of health services, took the lead in DM patients with insulin pump therapy to strengthen the standardization of the management study, and explored a nursing intervention program with effective treatment, and the promotion of patient self-care behavior change.Objectives(1) To explore the application and knowledge related requirement status on intensive treatment by insulin pump of patients with diabetes mellitus.(2) To explore the validity of standard management of intensive treatment by insulin pump to diabetes mellitus.Methodology1. Subject60 diabetic mellitus patients with intensive treatment by insulin pump according with studying rule enrolled into research in Shandong provincial hospital during 2007.2～2008.2.2. Methods60 diabetic mellitus patients of intensive treatment by insulin pump were investigated about diabetes mellitus insulin pump application and knowledge related by self-designed questionnaires. They were divided into experimental group and control group by 1:1 match. Then, for the experimental group, we adopted standard management, for the control group, traditional nursing. Blood glucose controlling, number of days of normal, dose of insulin, hypoglycemic episodes, breakdown, knowledge, technique related insulin pump were evaluated.3. Evaluating indicator(1) The status of intensive treatment by insulin pump to 60 diabetes mellitus patients.(2) To the level of blood sugar in the morning fasting blood glucose (FBG)3.5~ 7.0mmol/l, postprandial 2h blood glucose(PG2h) <9.0mmol/l, blood sugar before going to bed <8.0mmol/l,and is expected to more than 3d stability control objectives.(3) Standard-time, insulin dose: standard-time from the beginning of the treatment of capillary blood glucose to target the number of days, the dose of insulin from the beginning of treatment to the standard used by the total amount of insulin as well as during treatment per person per day per kilogram of body weight and amount of units of insulin, The amount of insulin units = total amount of insulin/(number of days treatment ?body weight).(4) The evaluation of knowledge and technique related insulin pump.(5) the number of the hypoglycemia, diabetes alkone sickness acidosis, the daybreak phenomenon, the insulin pump related breakdown (drive pipe to fall off, partial skin induration, injection spot infection and so on)4. Statistic MethodAll the data was processed by SPSS13.0 software package. The measurement material by Means±SD, and the group compares carries on the T-test, the counting material comparison and examines with chi square and Jizhi. As for two side test on a line, the eminent level a=0.05 should be accepted.Results (1) diabetic mellitus patients knew a little about insulin pump, and expected to receive knowledge education about insulin pump.(2) Two groups' blood glucose controlling was improved evidently, both tally with standardization (P<0.01), and the experimental group faster (P<0.05) .The experimental group's blood glucoses of two hours after breakfast and before sleeping were lower(3) The experimental group's hypoglycemic episodes and dawn phenomenon were lower than the control group (P<0.01) .(4) The experimental group's breakdown related insulin pump were lower than the control group significantly (P<0.01) .(5) Two groups' theoretical and technical knowledge related insulin pump were increased than before, the experimental group much better (P<0.05) .Conclusion(1) There were many problems about the application status of insulin pump, which influenced blood glucose controlling well, and should improve diabetic mellitus patients' cognition and complication to insulin pump.(2) Standard management of intensive treatment by insulin pump can control diabetic mellitus patients' blood glucose effectively, and decrease the incidence of related breakdown of insulin pump, and improve diabetic mellitus patients' theoretical and technical knowledge of intensive treatment by insulin pump.